Monday, June 01, 2009

Jackpot

Want to earn lots of money for your cardiology department? Just place an online "heart risk" assessment on your hospital's website and label 37.4% of the respondents "at risk:"

Since going live in late January, 7,072 people had completed the HeartAware assessment through early May, and 2,645 have been labeled "at risk."

"There's an awful lot of people who develop a bad event from heart disease on a yearly basis, not to mention the 8 or 9 million folks walking around with some form of blocked arteries and abnormal functions," said Dr. Vince Bufalino, medical director of cardiovascular services at Edward Heart Hospital.

"But when you look at the random public you wouldn't predict [these HeartAware at-risk numbers] up front," said Bufalino.

More than half of the at-risk test takers (1,597) accepted Edward's offer for follow-up services.

Wow. Think of all that testing, office visits and the like. Who knew?

Well someone did. Because with the stroke of a little logo change and voilà - another hospital in Maryland or Ohio or anywhere else you please can have the same assessment.

This is a program started by the HeartAware organization, a program of the National Heart Association. So who is the National Heart Association?

Well, I'm not sure. I'm not sure it's a real organization, but rather a front.

What I can tell you is that HeartAware is a product of Byrne Healthcare who labels this program as a "strategic marketing program for healthcare providers that identifies undiagnosed and at-risk individuals in their community that have disease and mobilizes them into their hospital or clinic." So it seems to me that the National Heart Association is really a marketing firm, and has nothing to do with heart health, other than to do marketing for hospital systems.

More impressive, they also have a whole line similar risk assessment tools for orthopedics, diabetes, stroke, sleep disorders, lung disease and cancer!

Now there certainly is nothing wrong with people being empowered with performing their tests online and seeing how their "risk bars" turn from "healthy green" to "threateningly red." But when Congress wants to look for ways to trim costs, maybe they should look at the fact that over 1/3rd of on-line people are found "at-risk" and a remarkably high number are undergoing testing that is likely to be of very low yield, moderate cost, has a real and significant false-positive rate to every test done that might incur more costs and more testing, and some of which might be quite invasive and carry significant risks.

But it's all about awareness, right?

Well, now you're aware that the so-called National Heart Association does not exist and maybe this prevention thing promoted by our President and government organizations to save costs in health care might just be doing the opposite.

5 comments:

Anonymous
said...

While there is no doubt that the Nat'l Heart Assoc is, as you say, a marketing company, there may be another explanation for the results found in the online risk assessment. First, there are probably very few healthy, under 50 year old's taking the assessment. Second, someone looking for a risk assessment survey online likely may be doing so for a reason such as they are a smoker, they have a family history etc. Again, I am not denying that your perspective is without merit, just bringing up the point that these types of surveys are not representative of a cross section of the population.

Free heart screenings for vulnerable individuals (those with multiple risk factors) seems like a good idea. My father was told that CT scans were a bad idea too. I told him otherwise and he subsequently had 2 stents put in which probably saved his life -- not to mention has changed his lifestyle dramatically. Certainly, marketing is at work here, but if it saves lives, I'm all for it.

we are just too medicalized. I am not sure how many lives are actually saved by these screenings...as a primary care doctor I am constantly explaining to people the rationale for screening and preventing unnecessary screening.Our attitude is to order a test just because it is there; and we need to follow through with all the possible ramifications of doing a test.Great post,keep up the good work.

After being told that I have an LBBB last year and my primary doctor brushing it off only to find 4 months later that I have atrial fibrilation and cardiomyopathy and at the end got a bivent implanted, I would bet to disagree. Screening can help find heart problems earlier. How many people just die suddnly from sudden cardiac arrest and no one will know why. I thought last year that I was just tired but boy I was wrong I had heart failure. Screening earlier might have caused an earlier diagnosis.

About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.